The present invention relates to surgical instruments for occluding a blood vessel or other body conduit, including jaw-type occlusion instruments such as surgical clamps and clips, and more particularly to cushioned pads, members or inserts that attach to the jaws of such clips or clamps for engagement with the target vessel or body conduit.
Instruments for occluding blood vessels and other body conduits, including jaw-type occlusion instruments, are well-known. In particular, surgical clamps commonly used for occlusion typically include pivoting jaw members that are moveable toward one another and which are actuated by handle members extending from the jaw members. The handle members typically include a ratchet mechanism to hold the engaged clamp in place. Surgical clips are commonly used to occlude smaller blood vessels and other body conduits during surgical procedures. A common type of surgical clip is the parallel jaw clip that includes a pair of jaws oriented generally parallel to one another and moveable from an open to a closed position. Many such clips include compression or extension springs for biasing the jaws together in the closed position. Representative of such clips are those described in, e.g., U.S. Pat. Nos. 3,509,882, 4,931,058, 5,653,720 and 6,267,773. Such clips have gained wide acceptance and are easy to place and remove, and provide for dependable occlusion, and are also useful for other applications, such as suture tags and identification markers.
Many conventional surgical clamps and clips are made of metal, such as stainless steel, hard plastic, or other similarly rigid materials. Such surgical clamps and clips are favored for a number of reasons. They can be manufactured to have a low profile, and the overall structural rigidity of the clamps or clips together with non-deflectable and non-deformable gripping surfaces provides for clamps and clips having good gripping properties. A disadvantage of such clamps and clips is that the hard surfaces and rigidity of the clamps can cause trauma to the clamped vessel at the site of occlusion.
As a result, a number of a traumatic versions of surgical clamps and clips have been developed for reducing trauma to a vessel during occlusion. In particular, such clamps and clips have been adapted to include jaw surfaces containing cushioned pads, members or inserts. In some cases these pads, members or inserts are prone to slipping off the clamped vessel, especially where the clamps or clips are engaged near the distal ends of their jaws. Also, due to the deformability of such pads, members or inserts, they likewise can be prone to slipping laterally along a clamped vessel, which can further result in a scissoring effect where the jaws twist off-line. In all such situations, effective clamping is compromised.
Efforts to improve a traumatic occlusion have included attempts to improve the tractive properties of the jaw inserts. These efforts include, for example, the provision of patterns of uniform raised protrusions, such as is disclosed in U.S. Pat. No. 6,099,539. Other efforts include, e.g., the provision of inserts formed of multi-composite materials. An example of such inserts include those disclosed in PCT Publication WO 99/11179 which consist of a compliant cushion covered with a mesh surface overlay.
There remains a need for a traumatic surgical clamps, clips, and accompanying jaw inserts that provide for improved gripping capabilities while minimizing trauma to an occluded vessel.
The present invention meets these and other needs and provides for jaw inserts for attachment to the jaws of jaw-type occlusion devices, such as surgical clamps and clips.
The invention resides in part on the surprising discovery that integrally formed raised patterns that extend only incrementally from the surface of a cushioned insert provide advantageous gripping traction while minimizing trauma to the gripped vessel. The raised patterns can extend as little as 0.006 to 0.010 inches from the gripping surface, significantly less than is typically found in conventional integrally formed inserts.
In one aspect of the invention, an insert is provided that includes a compliant cushion having a clamping surface adapted for engagement with a vessel or other body tissue. The clamping surface includes a plurality of integrally-formed raised patterns extending from the surface. The raised patterns are further characterized in that they are random and non-uniform in nature. In one variation of the invention, the raised patterns cover between approximately 40% to 70% of the total clamping surface of the insert. In another variation of the invention, the raised patterns extend approximately 0.006 to 0.010 inches from the clamping surface.
In another aspect of the invention, an insert is provided that includes a compliant cushion having a clamping surface adapted for engagement with a vessel or other body tissue. The clamping surface includes a plurality of uniform integrally-formed raised patterns extending from the surface extending approximately 0.006 to 0.010 inches from the clamping surface. In one variation, the raised patterns are a series of teeth-like ridges extending across the width of the cushion surface. In a further variation, the ridges are further formed such that the ridge faces directed toward the proximal end of the insert are perpendicular to the cushion surface, whereas the ridge faces directed toward the distal end of the insert are sloped. Such a design further discourages migration of clamped vessel toward the distal end of the insert. In another variation, the raised patterns are a series of repeating chevron patterns, also extending across the width of the cushion. In certain variations, the ridges or chevron patterns have an individual width of approximately 0.010 inches.
In further aspects of the invention, the inserts are configured for attachment to a surgical clamp or a surgical clip.
In yet further aspects of the invention, surgical clamps or clips are provided having at least one jaw having a compliant cushion having a clamping surface adapted for engagement with a vessel or other body tissue. The clamping surface includes a plurality of integrally-formed raised patterns extending from the surface.
The invention and its advantages will be even more apparent in view on the following description and accompanying drawings.